By chance, the very next email I looked at after this one was “Why Docs Won't Take Sick Time” http://www.hcplive.com/conference-coverage/idweek-2015/why-docs-wont-take-sick-time?utm_source=Informz&utm_medium=HCPLive&utm_campaign=Trending_News_10-14-15 As physicians, we are both the gatekeepers and the drivers of the sickness absence and fitness for duty systems. This makes it difficult for us to make decisions if the illness or injury affects us or a member of our own profession. There is fairly clear guidance on seizures in other safety sensitive positions (pilots, truck drivers etc.) and I think this guidance can be applied to surgeons and other safety sensitive positions in health care.

I don’t see that this post has been cross-posted to the MCOH List, so I will do so since this is a topic of mutual interest and MCOH members will undoubtedly have both opinions and experience with similar cases.

Bob Orford

Scottsdale, AZ

From: bounce-36805482-6838936@listserv.unc.edu [mailto:bounce-36805482-6838936@listserv.unc.edu] On Behalf Of Tee Guidotti
Sent: Wednesday, October 14, 2015 2:37 PM
To: Orford, Robert R., M.D.
Subject: Re: [occ-env-med-l] Surgeons with seizure disorders

I agree with individualizing the evaluation and guidance. This may not be as alarming as it sounds if the surgeon has a reliable aura well in advance, if the seizure is absence, if there is backup, and he or she is not doing major surgery. Then again, I would not want to have to explain a misadventure to a patient's family under the circumstances of an unpredictable Jacksonian seizure disorder.

The other side of this is the liability issue. Regardless of the fitness for duty and accommodation aspect of what is obviously a safety-sensitive position, would the liability insurance carrier and loss control accept this?

TLG

On Wed, Oct 14, 2015 at 4:04 PM, Upfal, Mark <mupfal@dmc.org> wrote:

Does anyone have any experience or know of any literature regarding surgeons with seizure disorders, and guidelines for returning to work/operating?

Has anyone seen the situation in which a surgeon must have someone else drive him/her to work due to a state reguation based driving restriction, but continues to operate?

How long should a surgeon be seizure-free before operating?

Mark Upfal, MD, MPH

Corp Medical Director, DMC Occupational Health Services

4201 Saint Antoine, UHC 4G-3

Detroit, MI 48201

(313) 993-0509

www.dmc.org/ohs

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